What is appendicitis gangrenous? Symptoms and treatment of the disease
Appendicitis gangrenous is characterized by necrotic changes of the appendix. However, total necrosis occurs in rare cases - usually the necrosis zone does not cover a very large part of the process.
Diagnosis of acute gangrenous appendicitis
Appendicitis gangrenous is manifested by a decrease or complete disappearance of previously strong pain sensations in the right side of the abdomen due to damage to the nerve apparatus of the appendix. The patient has nausea and vomiting( sometimes repeated), which does not bring relief. The general condition of the patient is severe due to severe intoxication, which also affects the pulse rate( 100-120 beats per minute).
The patient may also be bothered by stool changes: constipation or diarrhea. In most cases, the body temperature does not increase. The tongue is dry and has a white coating. Palpation of the abdomen causes severe soreness and muscle tension.
Diagnosis and treatment of the disease
The blood test is characterized by a slight leukocytosis or lack of an increase in the number of leukocytes. However, there is a marked shift of the leukocyte formula to the left. As for the analysis of urine, a protein appears in it.
The causes of appendicitis to date have not been fully established. But as scientists say, people who mostly eat meat, are more likely to develop appendicitis. Products in which a large number of animal protein, can cause putrefactive flow in the intestines, which predisposes to the development of such a disease as gangrenous perforated appendicitis.
The main way of infection of the shoot wall is enterogenic. Immediate pathogens of the disease are various microorganisms in the process, such as viruses, bacteria and protozoa.
If the time does not begin to treat appendicitis gangrenous, there comes a perforation. As a result, acute perforated appendicitis develops and all the contents of the appendix are found in the abdominal cavity. This leads to the onset of purulent peritonitis.
How to treat appendicitis? Is treatment possible without surgery? The answer is unequivocal - any form and stage of acute appendicitis is an absolute indication for appendectomy.
When diagnosed, appendicitis surgery is unavoidable, as there are no contraindications to it except for the patient's agonizing condition. The surgeon decides on the variant of the operation.
Technique for performing appendectomy
The traditional variant of apendectomy involves performing a cut of a small size of the abdominal wall. In the open wound, simultaneously with the cecum, a vermiform appendix is excreted. With the help of a resorbable thread, the mesentery that feeds it is bandaged, as well as the base of the appendage. Then the process is cut off, and the stump is treated with an antiseptic. After this, a suture stitch is placed on the cecum. The abdominal cavity is examined and drained with swabs. If there is a purulent effusion, the cavity is washed and drainage is left.
If you talk about a procedure such as appendicitis laparoscopy, it can be performed in two different ways. The method of Goetz implies the imposition of the endoptility from the absorbent thread( catgut) - the mesentery of the appendage coagulates. This method differs from the open technique in that in most cases the appendix stump does not sink into the cecum.
In the second technique, both the mesentery and the process are stitched with an endosurgical stapler. Thanks to a three-row seam of miniature titanium brackets, the joints are completely sealed, as well as good hemostasis - there is no further tissue reaction. In the second variant, complications occur 2-4 times less often than with the first, but it is significantly more expensive.
An open surgery is usually performed under anesthesia, less often - under local anesthesia. Laparoscopic surgery is performed only under anesthesia.